Remote Utilization Management Pharmacist

Humana Inc; Columbus (OH); On-site; USD 104,000 - 143,000; Full time

Benefits offered by this job

Paid time off

401(k) retirement savings plan

Employee assistance program

Job summary

Humana Inc. invites applications for a remote Utilization Management Clinical Pharmacist 2 (VSP/PT).

This role conducts medical necessity reviews and comprehensive medication reviews for pre-authorizations, intervenes to optimize cost-effective utilization and patient outcomes, and makes decisions with minimal direction in alignment with Humana’s strategy. The position supports remote work with occasional travel to Humana offices for training or meetings, and offers a comprehensive benefits

Qualifications

• Bachelor's degree or equivalent and less than 5 years of technical experience.

Responsibilities

• Complete medical necessity and comprehensive medication reviews for prescriptions requiring pre-authorization.
• Intervenes and advises patients and providers to promote cost effective utilization and quality patient outcomes.
• Interpret and determine appropriate course of action, sometimes in ambiguous situations, with minimal direction.
• Understands department, segment, and organizational strategy and operating objectives and their linkages to related areas.

Education

Bachelor's degree or equivalent

Job description

Humana Inc. invites applications for a remote Utilization Management Clinical Pharmacist 2 (VSP/PT).

This role conducts medical necessity reviews and comprehensive medication reviews for pre-authorizations, intervenes to optimize cost-effective utilization and patient outcomes, and makes decisions with minimal direction in alignment with Humana’s strategy. The position supports remote work with occasional travel to Humana offices for training or meetings, and offers a comprehensive benefits